KENISHA SHAWNTA PEMBERTON M.D.
NPI 1114289907
Family Medicine in Fort Leonard Wood, MO
About Kenisha Shawnta Pemberton M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENISHA SHAWNTA PEMBERTON M.D. (NPI 1114289907) is an individual family medicine provider in Fort Leonard Wood, Missouri, licensed in Florida (ME117245) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Sarasota.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kenisha Shawnta Pemberton M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 65473 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT LEONARD WOOD, MO 65473
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kenisha Pemberton's NPI number?
The NPI number for Kenisha Pemberton is 1114289907. It was assigned to this individual provider in the NPPES registry on June 8, 2012.
Where is Kenisha Pemberton located?
Kenisha Pemberton practices at 4430 Missouri Ave, Fort Leonard Wood, MO 65473. The listed phone number is (573) 596-0417.
What is Kenisha Pemberton's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kenisha Pemberton enrolled in Medicare?
Yes. Kenisha Pemberton is registered in the Medicare PECOS enrollment system.
What insurance does Kenisha Pemberton accept?
Health plans from Blue Cross and Blue Shield of Kansas, Inc. list Kenisha Pemberton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kenisha Pemberton was last updated on June 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kenisha Shawnta Pemberton, M.D. · NPI 1114289907
Family Medicine physician in Fort Leonard Wood, Missouri. Individual provider, active in the CMS NPPES registry since June 8, 2012.
## Identity
- **NPI:** 1114289907 (Entity type: Individual)
- **Enumerated:** June 8, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** ME117245 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 4430 MISSOURI AVE, Fort Leonard Wood, MO 65473-9098
- **Phone:** (573) 596-0417
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** June 14, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1114289907) · Data from the CMS NPPES public registry.